Jeff Lawson and Shawn Gage were surgeons who saw a problem and were determined to fix it.

Their dialysis patients frequently experienced painful complications like hematomas, blood that collects underneath the skin when a needle goes through both sides of a graft, bleeding from their access, or bulging aneurysms of their grafts from repeated needle punctures.

Exhausted and frustrated, Lawson and Gage sat down in the cafeteria in Duke Hospital, sketching potential solutions on a napkin.

What they came up with was so simple they thought someone had probably had the idea before. But after submitting their discovery to the Office of Licensing & Ventures (OLV), they found their idea was new.

With the help of partners Roberto Manson and Rob O’Reilly, they built their idea into a medical device company called InnAVasc. Lawson and Gage are still clinicians – but now, they’re also entrepreneurs.

Joe Knight, CEO of InnAVasc

InnAVasc provides a solution to help reduce frequent complications associated with hemodialysis vascular – the lifeline for patients who have kidney failure. Patients with end-stage renal failure must get their blood cleaned via dialysis three days a week for about four hours at a time.

Patients’ blood needs to be accessed both from the arterial side and the venous side. Traditionally, there are three main ways to access the blood: a large catheter can be inserted into the neck to access the large veins of the chest, a vein and an artery can be connected through a synthetic tube called a graft, or doctors can create what is called a fistula, taking the vein and attaching it directly to the artery.

“The challenge, of course, is that our veins, our arteries, any of these synthetic grafts – none of them were intended to be stuck with a needle three times a week,” said Joe Knight, a Fuqua ’11 graduate and InnAVasc’s CEO and president. “And so this leads to complications and eventually they fail.”

InnAVasc seeks to potentially reduce complications through a new design. While the product isn’t yet cleared for commercial sale, Knight said, “Our bench model data is very compelling and shows significantly improved performance compared to the current technologies that are out there.”

The team bootstrapped the company in its early days, leveraging resources available in the Duke ecosystem, including the MedBlue Incubator.

It was through the MedBlue Incubator that the pair connected with Knight.

Knight had spent five years at Medtronic helping with strategy, business development and marketing. He said this role allowed him to see what large corporations like Medtronic look for when acquiring smaller companies, much like the one he’s now spearheading.

But Knight had already been involved in entrepreneurship through Duke’s Program for Entrepreneurs and specifically in medical entrepreneurship through Stanford Unuiversity’s BioDesign Innovation Fellowship, which tasked its fellows with finding and solving the most pressing needs in medicine. Knight eventually decided it was time to leave Medtronic and pursue his passion for entrepreneurship.

Knight left Medtronic before he had another company to join. But it was a visit back to Duke that led him to his next role.

One of the principals of the MedBlue Incubator, Dani Bolognesi, introduced Knight to Lawson and Gage.

“I was on my way to the airport (to go back to Minneapolis) when I got a call from Dani,” Knight said. “He said, ‘I’ve got two physicians and you have to meet them.’”

Although he initially protested, worried about missing his plane, Bolognesi convinced him to turn around. He hit it off with Lawson and Gage immediately and saw they had a technology that was already pretty far along.

“They had this jetpack full of fuel that was ready to take off,” Knight said.

Knight joined the team in December 2015, and by 2016, the team was fundraising.

One year later, they’ve finished fundraising just under $2.9 million, with the Duke Angel Network as the lead investor.

InnAVasc has been issued patents in Europe and Australia and is still in discussions with the U.S. Patent and Trademark Office.

This year is important for the company, Knight said, because InnAVasc will continue discussions with the FDA about working through the regulatory process to bring the technology forward to aid hemodialysis patients.

Knight said he’s grateful he came back to Duke and for the resources InnAVasc has found there.

“I came back to the Triangle because I think the entrepreneurial ecosystem here has so much potential,” he said. “The team at the Duke Innovation & Entrepreneurship Initiative have been incredible assets, not just for Duke but I think for the whole community.”